ABSTRACT
Although most people infected with SARS-CoV-2 only experience mild respiratory manifestations, a subgroup of patients develop life-threatening acute respiratory distress syndrome. Unprecedented collaborative efforts across the biopharmaceutical industry, academic community, and regulatory agency have been extensively focused on rapid development of effective COVID-19 therapeutics during the last 3 years of the pandemic. Vaccines and monoclonal antibody treatment became widely available within the first year of the pandemic to effectively prevent the disease progression to severe conditions. Repurposed antiviral drugs and immunomodulators were approved or authorized for emergency use either at the early stage of SARS-CoV-2 infection or for hospitalized patients with severe COVID-19. However, the evolving variants continue alarming the community that the next outbreak of new viruses could is near and broad-spectrum antiviral therapies still have unmet need. In this chapter we outline the pathogenesis of SARS-CoV-2 and the correlated antivirals to treat COVID-19. We expect that our current understanding of the virus-host interaction driven by advanced omics profiling can expediate the new tractable drug target identification and drugging strategy revolution. We also anticipate that the repurposed compound libraries and disease model systems can facilitate the high throughput drug screen and efficacy test, thereby accelerating antiviral drug discovery to prevent the next pandemic.
